Part 1 - Parent / Guardian Information
Part 2 - Student Information
Part 2b - Student Information
Part 2c - Student Information
Part 3 - Photo / Video Release
Please note, you MUST check either the "Opt In" box OR the "Opt Out" box. Once you check one, the other will not be required.
I hereby, authorize Darby Creek Church (DCC), to publish the photographs and/or videos taken of any minor children and their names who have been stated on this form , for use but not limited to DCC printed publications, website or social media.
I give permission to DCC to copyright, use and publish the photographs and/or videos of my child(ren) with or without names for any lawful purpose, including illustrations, advertising and web content, social media posts, etc.
I release, all claims against DCC with respect to ownership and publication including any claims of compensation. I confirm that I am the parent or legal guardian of the minor child(ren) and have the authority to authorize to use their photographs and names.
I do not want any photos or videos of my child(ren) to be used in any church publication, website, social media, or in any other way.
All students named on this form have the permission of the undersigned to participate in Darby Creek Church events where he/she is driven in a vehicle by someone other than his/her own parent or guardian. This form is effective from September 1, 2019 through August 31, 2020.
In the event of an emergency affecting the health or welfare of this participant, the sponsors, leaders, or adult chaperones have permission to administer first aid and/or transport the individual to the nearest doctor or hospital for further medical attention, as deemed necessary. The individual action in response to the emergency will be held blameless. Any medical expenses occurring will be borne by the participant, orparents / guardians of the participant.
After pressing the SUBMIT button below, please wait 15 to 20 seconds and you will be taken to a "Thank You" screen confirming your form was submtted.